NAEMT Instructor Course, Second Edition

HOW TO SIMULATE INJURIES

Shock
1. Apply a thin coating of grease, powder, or other makeup product onto the face, ears, neck, hands, arms,
and legs.
2. Any body part that is immediately exposed or will be exposed during an assessment needs to be made up.
3. Blend the thin coating into the patient’s skin so that no blobs or streaks are obvious.
4. If using blue-based makeup, use only a small amount of blue and carefully blend it into the base makeup.
5. Apply either water using a spray bottle with a nozzle or glycerin onto the exposed body surfaces. Do not
spray in the volunteer patient’s eyes, nose, ears, or mouth.

Lacerations
1. Take a walnut-size amount of the plasteline or wax and roll it around in your hands to soften.
2. Flatten it out and apply it to the wound site.
3. Using a wooden tongue blade or an artist’s knife, smooth it out evenly onto the site.
4. Take the edge of the blade and draw a jagged line to simulate the laceration site.
5. Blend the plasteline or wax into the volunteer patient’s skin with makeup.
6. To add color to the laceration, use red liner, red fingernail polish, or warmed red latex gel as indicated by
the scenario.
7. Add small amounts of blood to the laceration.
8. Reapply before a new group of students arrives.
9. To make a laceration look even more realistic, use a combination of bleeding bags, simulated blood,
warmed red latex gel, and coagulated blood.
a. For venous bleeding, use coagulated blood, thick simulated blood, or red latex gel.
b. For arterial bleeding, use a bleeding bag with simulated blood.
10. Bleeding bag lines can be hidden under a wound. The line can be taped onto the volunteer patient, with
the plasteline or wax applied on top of the line.
11. Avoid getting simulated blood on human hair or clothing because simulated blood products stain.

Abrasions
1. Use a stipple sponge and red grease liner to draw abrasions on the volunteer patient’s skin.
2. Black or brown color and dirt or charcoal can be added with some dabs of simulated blood.
3. Avoid getting simulated blood on human hair or clothing because simulated blood products stain.

@2022 National Association of Emergency Medical Technicians (NAEMT). Course materials are developed by NAEMT for the sole purpose of conducting NAEMT
education courses and may not be utilized for any other purpose.
 NAEMT Instructor Course, Second Edition

Bruises
1. Grease liners and eye shadow liners can be used to simulate bruises.
2. To simulate an older bruise, apply a light coating of yellow first and blend it in; then apply the light green
and blend it in.
3. To simulate a healing bruise, combine blue and red to make a light purple color. Apply a small amount of
the purple liner to the middle of the bruise site.
4. To simulate a more recent bruise, use red and blue colors without any premixing. Blend the colors right
onto the skin. Apply a red eye shadow or grease liner first, and then blend in the blue. Recent bruises have
bolder colors than week-old bruises.

Fractures
1. Plasteline or wax can be used to simulate closed or open fractures.
2. Apply the material to the volunteer patient’s skin and smooth it out.
3. Next, apply an additional piece on top of the initial coating.
4. Apply natural-colored makeup to blend the material into the volunteer patient’s skin.
5. A compound fracture can have pieces of simulated bone embedded into the simulated injury. Add several
lacerations and simulated blood for the final touch. A hidden bleeder line can even be added to heighten
the realism of the scene.

Burns
1. Apply a thin layer of petroleum jelly to the volunteer patient’s skin.
2. Apply ripped pieces of tissue paper to the petroleum jelly.
3. Apply an additional thin coating of petroleum jelly on top of the tissue paper.
4. Using a pencil or pen, begin to lift up the tissue paper into little mounds, and place small tears in the
paper; this creates second- and third-degree burn areas.
5. Next, add color to the wound with a red grease liner. Take dabs of the grease liner and dot the outer area
of the burn.
6. Use both brown and black grease liners to highlight the second- and third-degree burn areas.
7. Apply dirt and gravel to the entire burn area.
8. Apply coagulated blood.

Amputations
1. To simulate a thumb amputation, first flex the volunteer patient’s thumb inward toward the palm. Use
tape to hold it in place.
2. Apply a piece of wax onto the bent thumb and mold to simulate a stump.
3. Blend natural grease coloring into the wax to match the volunteer patient’s skin color.
4. Apply red grease liner to the bent thumb to simulate the detached portion.
5. Apply simulated blood.
6. Place a fake thumb near the volunteer patient.

@2022 National Association of Emergency Medical Technicians (NAEMT). Course materials are developed by NAEMT for the sole purpose of conducting NAEMT
education courses and may not be utilized for any other purpose.
 NAEMT Instructor Course, Second Edition

Sucking chest wound

1. Apply plasteline or wax to the volunteer patient’s chest.
2. Make a depression the size of a nickel into the wax.
3. Break an antacid tablet into pieces and insert them into the depression.
4. Pour several drops of diluted simulated blood onto the tablet and watch the area bubble. The tablet may
bubble for 45 minutes.
5. To simulate subcutaneous emphysema, use plastic packing air bubbles. Position a sheet on the chest, and
then have the volunteer patient wear a shirt over the bubbles. As a student assesses the chest region, the
bubbles will pop and move around just like real subcutaneous emphysema.

@2022 National Association of Emergency Medical Technicians (NAEMT). Course materials are developed by NAEMT for the sole purpose of conducting NAEMT
education courses and may not be utilized for any other purpose.